The Louisiana State University Health Sciences Center in New Orleans (LSUHSC) MB-CCOP has been providing access to clinical trials to African American and other minority populations in the city and surrounding regions since 1994. In August of 2005, the city was hit by Hurricane Katrina, the worst natural and social disaster to occur in the US since the Civil War. New Orleans experienced the largest mass migration of any US city, and the largest physician migration. LSUHSC, in particular, lost Charity Hospital, its principal enrollment site. It also lost virtually all adult oncologists and support MB-CCOP personnel, and the program's patients were dispersed. A new MB-CCOP leadership implemented an immediate response plan and established a long term reorganization strategy. The immediate response plan enabled us to recruit a team that tracked 90% of the patients by fall 2006, recovered the medical records of these patients, and reestablished follow-up. The long term plan aimed to rebuild the MB-CCOP infrastructure around a private-public partnership with community oncologists. Within two years, these partnerships allowed us to significantly increase our enrollment, maintaining our commitment of providing access to state-of-the-art clinical trials to minority and underserved patients. This paradigm shift from a single site, centrally based MB-CCOP to a community-based, multi-center program also allowed us to begin systematically analyzing the different barriers to minority patient enrollment in the private and public healthcare settings. The goal of our renewal application is to address these barriers and enhance the participation of minorities in MB-CCOP clinical trials. This will be accomplished through three Specific Aims directed at 1) expanding MB-CCOP activities at public hospitals and the state's cancer screening clinics, 2) promoting MB-CCOP activities through private oncology partnerships, and 3) developing targeted community outreach educational programs.